Nomograms for predicting risk of locoregional recurrence and distant metastases for esophageal cancer patients after radical esophagectomy

Abstract

BackgroundThe aim of this study was to develop nomograms for predicting the risk of locoregional recurrence or distant metastasis in esophageal cancer patients who were treated with esophagectomy and regional lymphadenectomy.MethodsThe clinicopathologic data of 408 esophageal cancer patients after esophagectomy and regional lymphadenectomy were analyzed in this study. Univariate and multivariate COX regression analyses were used to test the association between the clinicopathologic data and the risk of locoregional recurrence or distant metastasis. The nomograms were built from the COX regression model.ResultsUnivariate analyses revealed that tumor length, tumor width, T-staging and perineural invasion(PNI) were significantly associated with locoregional recurrence, and that tumor length, tumor width, differentiation, T-staging, N-staging, lymph vascular space invasion(LVSI), PNI and adjuvant chemotherapy were significantly associated with distant metastasis. Multivariate analyses revealed that tumor length, tumor width and T-staging were predictors of risk of locoregional recurrence, and that differentiation, N-staging, LVSI and PNI were predictors of risk of distant metastasis. Two nomograms were constructed for a visual explanation of these two COX regression models. The bias-corrected curve showed no significant departure from the ideal curve in these two nomograms.ConclusionsTwo nomograms were developed and validated to predict the risk of locoregional recurrence and distant metastasis in esophageal cancer patients after radical esophagectomy. The calculation outcome will help oncologists to choose adjuvant treatment regimens.

Established and Validated Novel Nomogram for Predicting Prognosis of Post-Mastectomy pN0-1 Breast Cancer without Adjuvant Radiotherapy

“…Nomograms are frequently used not only for predicting survival in patients with all types of cancer but also for successfully quantifying risk prediction according to clinicopathological variables. [12][13][14][15] Although many of the available decision tools, such as CancerMath, 16 PREDICT 17 and the ipsilateral breast tumor recurrence program (IBTR), 18,19 have been established to predict survival probability in breast cancer patients, none of these tools are established specially based on the post-mastectomy breast cancer with pN0-1 without adjuvant radiotherapy. As a result, we perform the present study to establish and validate a nomogram based on a large sample size for predicting prognosis of post-mastectomy breast cancer with pN0-1, but without adjuvant radiotherapy, which could be used for adjuvant treatment counseling after mastectomy.…”

Established and Validated a Novel Nomogram for Predicting Prognosis of Post-mastectomy pN0-1 Breast Cancer Without Adjuvant Radiotherapy

“…In addition, in a recently retrospective study published by Muhsen S. et al, the authors found that nearly 85% of patients with T1-2N1 could spare PMRT due to the low incidence of LRR [10], As a result, the role of adjuvant postmastectomy radiotherapy (PMRT) in early stage breast cancer remains controversial, and an accurate prognostic indicator to identify patients who at high risk for recurrence is clearly needed for physicians when giving individualized clinical decision making. Nomograms are frequently used not only for predicting survival in patients with all types of cancer but also for successfully quantifying risk prediction according to clinicopathological variables [11][12][13][14]. Although many of the available decision tools, such as CancerMath [15], PREDICT [16] and the ipsilateral breast tumor recurrence program (IBTR) [17,18], have been established to predict survival probability in breast cancer patients, none of these tools are established specially based on the post-mastectomy breast cancer with pN0-1 without adjuvant radiotherapy.…”

Nomograms Predict Survival Advantages of Gleason Score 3+4 Over 4+3 for Prostate Cancer: A SEER-Based Study

“…Nomograms have been widely proposed as new standards to predict the occurrence and prognosis of various cancer types, including esophageal cancer (13), rectal cancer (14), bladder cancer (15). With regard to prostate cancer, several groups have investigated prognostic nomograms in prostate cancer (16–18).…”